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Biomedical subjects

S K Mehta

Publications and source records attributed to S K Mehta.

At least 235 records · Page 13Linked to original sources
PubMedDate not supplied

Endoscopic fine needle aspiration biopsy of gastroesophageal malignancies.

We have evaluated the results of endoscopic fine needle aspiration cytology in 50 consecutive cases of suspected malignancy of the esophagus and stomach and compared them with those of forceps biopsy and brush cytology. The diagnostic yield with forceps biopsy, fine needle aspiration, and brush cytology in 46 cases of carcinoma was 88.8%, 89.1%, and 80.4%, respectively. A combination of forceps biopsy and brush cytology gave an accuracy of 93.5% while the addition of fine needle aspiration increased the yield to 100%. This was due to a very high positive yield of fine needle aspiration in infiltrative tumors.

Adenocarcinoma↗
PubMedDate not supplied

A comparative evaluation of sclerosants for esophageal varices: a prospective randomized controlled study.

The aim of this prospective randomized controlled study was to find a safe and effective sclerosing solution for endoscopic injection sclerotherapy in the treatment of esophageal variceal bleeding. Ninety consecutive patients with portal hypertension and variceal bleeding were randomized to receive sclerotherapy with 5% ethanolamine oleate, 3% sodium tetradecyl sulfate, or absolute alcohol at an interval of 3 weeks. Sixty-four patients who received more than three sessions were analyzed. All three agents were found to have similar success and complication rates (p greater than 0.05). However, absolute alcohol required fewer sessions (p less than 0.01) and lesser amounts (p less than 0.01) to produce successful variceal sclerosis and had the added advantage of low cost and easy availability.

Adult↗
PubMedDate not supplied

The role of fiberoptic endoscopy in the management of corrosive ingestion and modified endoscopic classification of burns.

We prospectively evaluated the role of fiberoptic esophagogastroduodenoscopy in the management of 81 patients with corrosive ingestion. A total of 381 endoscopic examinations were performed: 88 within 96 hours following corrosive ingestion, 108 between the third and ninth week, and 185 during the period of follow-up after bougie dilation of esophageal strictures. The customary endoscopic classification of burns (grades 0 to 3) was modified by subdividing grade 2 burns into 2a and 2b, and grade 3 burns into 3a and 3b for prognostic and therapeutic implications. There was no significant correlation between oropharyngeal and upper gastrointestinal tract injury. Early major complications and deaths were confined to patients with grade 3 burns. All patients with grade 0, 1, and 2a burns recovered without sequelae. The majority of patients (71.4%) with grade 2b injury and all survivors with grade 3 injury developed esophageal or gastric cicatrization, or both, which needed endoscopic or surgical treatment. There were no complications related to endoscopy. We conclude that early endoscopy is not only a safe, reliable, and accurate diagnostic tool in such patients, but also is of crucial importance in management and prognosis.

Adult↗
PubMedDate not supplied

Outcome of injection sclerotherapy using absolute alcohol in patients with cirrhosis, non-cirrhotic portal fibrosis, and extrahepatic portal venous obstruction.

In order to assess the comparative efficacy and safety of endoscopic injection sclerotherapy in patients with portal hypertension of different etiology, i.e., cirrhosis, non-cirrhotic portal fibrosis, and extrahepatic portal venous obstruction, 87 patients with variceal bleeding were initiated on sclerotherapy using absolute alcohol. There was no significant difference in the success rate of sclerotherapy as well as in the number of sessions and volume of alcohol required for variceal obliteration between the three groups. Major complications included esophageal ulcers (30.0%), symptomatic strictures (18.6%), and interval re-bleed (17.1%) with similar complication rates for the three groups (p greater than 0.05). There was no difference between patients with Child's class A cirrhosis compared with classes B and C together with respect to efficacy and complications of sclerotherapy. Fifty patients (25 cirrhosis, 11 non-cirrhotic portal fibrosis, and 14 extrahepatic portal venous obstruction) with complete variceal obliteration were followed up for a mean period of 16.5 months. Sixteen patients (32%) had variceal recurrence, but bleeding due to recurrent varices occurred in only one case. There was no difference among the three groups for overall variceal recurrence, although recurrence tended to be somewhat later in extrahepatic portal venous obstruction (9.4 +/- 4.0 months) compared with that in cirrhosis (5.1 +/- 3.6 months) and non-cirrhotic portal fibrosis (4.8 +/- 2.6 months).

Adolescent↗
PubMedDate not supplied

Immunological significance of Aspergillus fumigatus in cane-sugar mills.

An aeromycological study has revealed the preponderance of Aspergillus fumigatus at the bagasse-containing sites in sugar-cane mills located in the northwestern part of the Punjab State. The fungus was frequently isolated from the sputum cultures of the mill workers and a significant number of the workers were positive reactors when challenged intracutaneously with aspergillin. Immediate Type I and late Arthus Type skin hypersensitivity was observed in 10.6% and 4.4%, respectively, of the 548 workers investigated. Incidence of hypersensitivity was particularly high among workers having chronic respiratory problems. During a sample survey of 238 workers having chronic respiratory diseases, diagnoses of allergic bronchopulmonary aspergillosis, and allergic bronchopulmonary candidiasis based on positive clinical and laboratory findings, were made in 17 (7.1%) and in only 4 (1.7%) of the cases, respectively. Evidence is presented to support that the epidemiology of allergic bronchopulmonary aspergillosis, but not of allergic bronchopulmonary candidiasis, may have an occupational dimension.

Aspergillosis, Allergic Bronchopulmonary↗
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Use of algae for removing heavy metal ions from wastewater: progress and prospects.

Many algae have immense capability to sorb metals, and there is considerable potential for using them to treat wastewaters. Metal sorption involves binding on the cell surface and to intracellular ligands. The adsorbed metal is several times greater than intracellular metal. Carboxyl group is most important for metal binding. Concentration of metal and biomass in solution, pH, temperature, cations, anions and metabolic stage of the organism affect metal sorption. Algae can effectively remove metals from multi-metal solutions. Dead cells sorb more metal than live cells. Various pretreatments enhance metal sorption capacity of algae. CaCl2 pretreatment is the most suitable and economic method for activation of algal biomass. Algal periphyton has great potential for removing metals from wastewaters. An immobilized or granulated biomass-filled column can be used for several sorption/desorption cycles with unaltered or slightly decreased metal removal. Langmuir and Freundlich models, commonly used for fitting sorption data, cannot precisely describe metal sorption since they ignore the effect of pH, biomass concentration, etc. For commercial application of algal technology for metal removal from wastewaters, emphasis should be given to: (i) selection of strains with high metal sorption capacity, (ii) adequate understanding of sorption mechanisms, (iii) development of low-cost methods for cell immobilization, (iv) development of better models for predicting metal sorption, (v) genetic manipulation of algae for increased number of surface groups or over expression of metal binding proteins, and (vi) economic feasibility.

Biodegradation, Environmental↗
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Evaluation of portable air samplers for monitoring airborne culturable bacteria.

Airborne culturable bacteria were monitored at five locations (three in an office/laboratory building and two in a private residence) in a series of experiments designed to compare the efficiency of four air samplers: the Andersen two-stage, Burkard portable, RCS Plus, and SAS Super 90 samplers. A total of 280 samples was collected. The four samplers were operated simultaneously, each sampling 100 L of air with collection on trypticase soy agar. The data were corrected by applying positive hole conversion factors for the Burkard portable, Andersen two-stage, and SAS Super 90 air samplers, and were expressed as log10 values prior to statistical analysis by analysis of variance. The Burkard portable air sampler retrieved the highest number of airborne culturable bacteria at four of the five sampling sites, followed by the SAS Super 90 and the Andersen two-stage impactor. The number of bacteria retrieved by the RCS Plus was significantly less than those retrieved by the other samplers. Among the predominant bacterial genera retrieved by all samplers were Staphylococcus, Bacillus, Corynebacterium, Micrococcus, and Streptococcus.

Air Microbiology↗
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Nocturnal gastric acid secretion in duodenal ulcer: inhibition by cimetidine.

The inhibitory effect of cimetidine 200 mg, cimetidine 400 mg, cimetidine 200 mg + oxyphenonium bromide 10 mg and placebo was studied on nocturnal gastric acid secretion in 10 patients with duodenal ulcer. Each patient was studied over a period of four nights and trial medication was given in a randomized sequence. Cimetidine in both doses significantly inhibited the nocturnal gastric acid secretion. The drug reduced both the H+ concentration and gastric juice volume but the reduction of H+ concentration was more impressive. Mean percentage inhibition of nocturnal acid output with cimetidine 400 mg (89.6 +/- 2.868) was significantly higher than cimetidine 200 mg (80.3 +/- 4.085; p less than 0.01). Combination of cimetidine 200 mg and oxyphenonium bromide 10 mg was significantly better than cimetidine 200 mg alone (p less than 0.05) and this combination produced inhibition of gastric juice volume, H+ concentration and acid output comparable to cimetidine 400 mg.

Cimetidine↗
PubMedDate not supplied

Fulminant viral hepatitis: Indian experience.

Thirty-six patients with fulminant viral hepatitis were studied. Enzyme immunoassay was used to detect the presence of HBsAg, IgM anti-HBc, and IgM anti-HAV. Non-A, non-B virus was the most common aetiological agent (61.1%) followed by hepatitis B virus (HBV; 30.6%) and hepatitis A virus (8.3%). Presence of IgM anti-HBc confirmed the diagnosis of HBV infection in three cases who were negative for HBsAg. Similarly, in one case who was positive for HBsAg, absence of IgM anti-HBc suggested superinfection with some other agent. Survival was significantly higher (P less than 0.01) in the hepatitis A virus (HAV) group (66.6%) compared with non-A, non-B (31.2%) and HBV groups (27.3%). Fever at the onset of illness was seen in all patients with HAV, 54.5% of patients with HBV and 38.88% of patients with non-A, non-B infection (P less than 0.01). The median time interval between the first symptom and the onset of encephalopathy was 16, 13 and 8 days in HAV, HBV and non-A, non-B groups, respectively, but this difference was statistically not significant (P greater than 0.05).

Adult↗
PubMedDate not supplied

Effect of smoking on gastric acid secretion in patients with duodenal ulcer.

The effect of smoking on gastric secretion was studied in 15 consecutive patients with duodenal ulcer--six normosecretors (basal acid output less than or equal to 3 mEq/h), and nine hypersecretors (basal acid output greater than 3 mEq/h). The volume, acid output, acid concentration, and pH of the gastric juice measured before, during and after 1 h of smoking did not show any significant difference in these patients taken as a single group, or when the normosecretors and hypersecretors were analysed as separate groups (P greater than 0.05 for each parameter in each group). The higher acid output before and during smoking in hypersecretors than in normosecretors was due to the higher acid concentration in the gastric juice (P less than 0.01). Study of the pH curves of the gastric juice after acute smoking showed that hypersecretors had a lower pH for a longer duration compared with normosecretors. This could make the hypersecretors with a history of chronic smoking more prone to developing duodenal ulcer.

Adult↗
PubMedDate not supplied

Evaluation of fibronectin as a marker of malignant ascites.

The aim of the study was to assess the accuracy of fibronectin, a glycoprotein, for the diagnosis of malignant ascites and to compare it with conventional parameters. Ascitic fluid samples from 50 patients, 25 with intra-abdominal malignancy and 25 without it were analysed for total protein concentration, fluid/serum protein ratio, glucose concentration, leucocyte count, pH, fibronectin concentration (by ELISA) and for malignant cell cytology. Twenty-two of the 25 patients with ascites and intra-abdominal malignancy had documented peritoneal metastases in group A. The 25 patients with non-malignant ascites constituted group B. Mean values of ascitic fluid fibronectin, for groups A and B were 538 +/- 46 micrograms/mL and 60 +/- 4.92 micrograms/mL, respectively (P less than 0.001). Within the group with malignant ascites, patients who had positive malignant cytology (n = 12) exhibited a significantly higher ascitic fluid fibronectin concentration than patients with negative cytology (P less than 0.05). While mean ascitic fluid protein concentration showed a significant difference (P less than 0.01) between the two groups, there was no difference in respect to ascitic fluid pH, glucose concentration and leucocyte count. Malignant cell cytology was positive in 54.5% of group A patients with no false positive report in group B. The diagnostic accuracy for differentiating malignant from non-malignant ascites was 100% for a fibronectin value of greater than or equal to 110 micrograms/mL as compared with 78.7% for ascitic fluid protein concentration greater than or equal to 0.5 g/dL, 57.4% for leucocyte count greater than or equal to 1000/mm3, 59.6% for pH less than 7.45 and 78.7% for malignant cell cytology.

Abdominal Neoplasms↗
PubMedDate not supplied

Crush preparations of gastroesophageal biopsy specimens in the diagnosis of malignancy.

The diagnostic value of crush preparations of endoscopic biopsy samples from gastroesophageal malignancies was studied. Forty-two patients with esophageal or gastric carcinomas were subjected to endoscopic biopsy and brushing. Half of each of two biopsy pieces from each case was crushed between two glass slides for cytologic evaluation. A positive yield (a diagnosis of malignancy) was achieved by histologic study of biopsy samples in 38 cases and by cytologic study of brushing smears in 37 cases and crush preparations in 40 cases. The advantages of the cytologic study of crush preparations were: (1) it expedited the workup of the patients and (2) it gave a positive yield in cases whose biopsy specimens were otherwise inadequate for making a definitive histologic diagnosis. Crush preparations thus combined the usefulness of biopsy and brushing techniques for the diagnosis of gastroesophageal malignancies.

Adenocarcinoma↗
PubMedDate not supplied

Endoscopic suction cytology in upper gastrointestinal tract malignancy.

In 50 cases of radiographically suspected malignancies of the upper gastrointestinal (GI) tract, the lesions were sampled by suctioning following brushing and forceps biopsy. The cytologic smears prepared from the suctioned material were positive for malignancy in 48 cases (96%), as were the biopsy specimens; the cytologic smears from the brushings were positive in 92% of the cases. All 50 cases were diagnosed as malignant by one or more of the techniques. Suction cytology detected the ulcerated and stenotic growths that biopsy failed to diagnose in two cases. Endoscopic suction cytology, which is a simple and rapid procedure, seems able to assist in diagnosing lesions of the upper GI tract.

Adenocarcinoma↗
PubMedDate not supplied

Endoscopic fine needle aspiration biopsy.

A catheter assembly that can be passed through the biopsy channel of a standard fiberoptic gastroduodenoscope was devised to permit fine needle aspiration biopsy of gastrointestinal neoplasms under direct vision of the endoscope. This technique for endoscopic aspiration biopsy was performed in ten consecutive patients with esophageal and gastric carcinomas, along with the conventional endoscopic brushing and biopsy. Endoscopic aspiration biopsy gave a positive diagnosis in all ten cases while the other two techniques gave inconclusive results in one patient with an ulcerative growth. We feel that endoscopic aspiration biopsy can be used to obtain representative samples from gastrointestinal neoplasms, and it may add to the diagnostic accuracy of endoscopic biopsy and brushing cytology.

Adenocarcinoma↗